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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by PhoenixGirl on March 3, 2001, at 15:35:40
I want to hear from people who treat their depression with a stimulant, do not have ADD, and also have not developed tolerance to the stimulant. I want to see if this is possible, or how likely it is. Thanks
Posted by Leonardo on March 4, 2001, at 7:27:09
In reply to Who has depression without ADD, and takes stims?, posted by PhoenixGirl on March 3, 2001, at 15:35:40
I don't quite fit your category as I *believe* I have ADHD and depression, and as I have only just started taking stims I don't know about long term effects from my own experience.
However, I do know that it is generally frowned upon to prescribe the stims for depression as they are believed to be short lasting and addictive if used to treat fatigue and/or depression.
Not all Pdocs agree with this this, and some support the idea of usind stims as an antidepressant, though they seem to be in the miniority. My Pdoc seems to think that in the case of developing a tolerance after a while, it would be OK to up the dose, within some limits I guess. However, you need to be careful about starting on a low dose and working up gradually, or you may get a bad response which doesn't settle down later on. My experience of Ritalin and dex is that you get a very strong response on the first doses, which doesn't occur again later, and if you over do it at first, the later responses may be erratic.
Some people may have depression resulting from ADHD without actually realising they have ADHD (which was true in my case), as the symptoms tend to be less pronounced in adults.
See:
http://www.btinternet.com/~black.ice/addnet/cosgrove.html
Under 'Future Ideas - Adult Psychiatry' it says:
"At a psychopharmacology conference in Belfast organized by the British Association for Psychopharmacology, a desire for better and more consistently effective antidepressant drugs was expressed. It was suggested that adult psychiatry did not have to wait for the pharmaceutical industry to produce yet another antidepressant because Ritalin and dexamphetamine have considerable antidepressant properties in and of themselves. The dopaminergic system is recognized as being involved in the experience of pleasure, and both electroconvulsive therapy and a number of dopamine facilitating drugs (e.g. monoamine oxidase inhibitors and dopamine agonists, bromocriptine and piribedyl, and the dopamine reuptake inhibitor, buproprion) are known to relieve depression through their effects on dopamine [60]. Biederman’s family study [18] that first degree relatives of known ADHD sufferers are 2.4 times more likely to suffer from depression should alert adult psychiatry to the value of trying Ritalin or dexamphetamine in cases of adult depression with a family history of ADHD. Certainly, the drug treatment of ADHD in children characteristically raises self-esteem and makes the chronically unhappy child observably happier. It would be surprising if this did not also occur in adult ADHD sufferers."
Leonardo
> I want to hear from people who treat their depression with a stimulant, do not have ADD, and also have not developed tolerance to the stimulant. I want to see if this is possible, or how likely it is. Thanks
Posted by Noa on March 5, 2001, at 8:06:59
In reply to Re: Who has depression without ADD, and takes stims? » PhoenixGirl, posted by Leonardo on March 4, 2001, at 7:27:09
I don't have ADD, and have been taking stimulants to augment my ADs. I currently take adderall.
I haven't developed a tolerance. However, I did experience withdrawal symptoms when I went without the adderall for two days due to lack of prescription. I felt very cranky and out of sorts.
I used to take ritalin, then ritalin SR (both generic) and found they helped a little, but when I started the Adderall, the difference was very obvious. I immediately felt so much more calm and focused on the Adderall (Remember--this is my experience--YMMV).
At one point, my pdoc hypothesized that I may have had undiagnosed ADD, but I am not sure. I think I have some symptoms that overlap both the depression/anxiety sphere and the ADD sphere.
Also, because my depression is partly caused by hypothyroidism, I had cognitive fuzziness, and fatigue, and stimulants do help with that.
There is an article in the thryoid and depression folder about using dexedrine to treat anergic depression assoc. with hypothyroidism, fwiw.
Posted by Leonardo on March 5, 2001, at 12:57:23
In reply to Re: Who has depression without ADD, and takes stims?, posted by Noa on March 5, 2001, at 8:06:59
> Also, because my depression is partly caused by hypothyroidism, I had cognitive fuzziness, and fatigue, and stimulants do help with that.
>
Hi NoaHow can you tell if you have hyperthyroidism? I have the cognitive fuzziness and fatigue which made me suspect thyroid at one point. I got my very-unconvinced GP to do a blood test for thyroid activity which came back 'within normal range'.
I also heard that these blood tests are not very reliable... How can I rule it out for sure? I am responding quite well to dex, so you've got me thinking about this again!
Leonardo
Posted by JohnL on March 6, 2001, at 5:00:52
In reply to Who has depression without ADD, and takes stims?, posted by PhoenixGirl on March 3, 2001, at 15:35:40
> I want to hear from people who treat their depression with a stimulant, do not have ADD, and also have not developed tolerance to the stimulant. I want to see if this is possible, or how likely it is. Thanks
I fit this description. However, there is only one stimulant that works well for me, which is Adrafinil. All the others were pretty lousy experiences.
John
Posted by Cece on March 6, 2001, at 14:03:23
In reply to Re: Depression without ADD, stims, thyroidism? » Noa, posted by Leonardo on March 5, 2001, at 12:57:23
For years, I was told that my thyroid was "on the lower end of within normal limits". Then last month my pdoc ordered very specific tests :
T4, T Uptake, FTI, and TSH. Because I take Cytomel (T3) as an AD augmenter, I had to have the blood drawn before took my daily dose of that.
Two of the tests, T4 and FTI, came back "borderline low", below normal limits.
Since then I have been taking T4 supplement (Levothroid, 50mg/day), and have experienced significant improvement in energy level.
Whether my levels had changed over the years, or I had just not had complete enough testing done is impossible to know.
T4 makes T3 in the body (an oversimplification I'm sure!), so simply supplementing T3 does not fix the problem if T4 is low to begin with.
There is also a very respected pdoc, Peter Whybrow, who advocates treating depression with thyroid supplement even if the tests appear normal, which apparently helps some people.I also recently began taking Adderall- it is unclear whether I have "full-blown" ADD, although some of my problems, being very distractable, daydreaming, and focussing, fit the profile. I can't handle much Adderall without becoming unpleasantly wired, but just 7.5mg/ morning, and 2.5mg/afternoon, has helped me focus much better on the task at hand and has reduced my tendency to wander off into daydreaming.
Good luck,
Cece
> How can you tell if you have hyperthyroidism? I have the cognitive fuzziness and fatigue which made me suspect thyroid at one point. I got my very-unconvinced GP to do a blood test for thyroid activity which came back 'within normal range'.
>
> I also heard that these blood tests are not very reliable... How can I rule it out for sure? I am responding quite well to dex, so you've got me thinking about this again!
>
> Leonardo
Posted by Noa on March 6, 2001, at 14:28:17
In reply to Re: Depression without ADD, stims, thyroidism? » Leonardo, posted by Cece on March 6, 2001, at 14:03:23
Leonardo, I encourage you to read the material in the thyroid and depression folder, which has a link at the top of the psychobabble page. There is a lot of info there about hypothyroidism. Cece's post is also very helpful.
Posted by JahL on March 9, 2001, at 10:00:49
In reply to Re: Depression without ADD, stims, thyroidism? » Noa, posted by Leonardo on March 5, 2001, at 12:57:23
> > How can you tell if you have hyperthyroidism? I have the cognitive fuzziness and fatigue which made me suspect thyroid at one point. I got my very-unconvinced GP to do a blood test for thyroid activity which came back 'within normal range'.Hi Leonardo. I too have this 'cognitive fuzziness' & consequently asked my ( similarly unimpressed) GP for thyroid tests. He informed me they were 'normal'. However it was only when I asked 4 a print-out the other day that I realised only TSH & total T4 had been measured; wholly inadequate according to Cece's post!
I think it's just another case of the UK being woefully behind the States in terms of medical advancements.
My current US pdoc says that *Thyroid responders often do well initially on stimulants, only for the effect to fade with time. Addition of thyroid restores the improvements in such cases*. (He has published these findings)
With this in mind I would strongly urge you get a thorough *private* thyroid evaluation. You've nothing to lose! The Mary Shamon (sp?) thyroid site (accessible through Noa's Tips) has some excellent pieces on deciphering yr results.
Let us know how you get on-I would be interested to know since my dad also suffers from extreme brain fog. I'm trying to get him to get a thyroid evaluation, but he (understandably) doesn't have much time for doctors.
BTW, like you I'm dx'd depression/ADD. I've just started Lamactil & tho' I'm only on a small dose (37.5mg) my mind has already 'cleared' *immeasuably*. No other drug has ever managed this. Just a thought.
Jah.
> I also heard that these blood tests are not very reliable... How can I rule it out for sure? I am responding quite well to dex, so you've got me thinking about this again!
>
> Leonardo
Posted by Lee on March 10, 2001, at 10:15:02
In reply to Who has depression without ADD, and takes stims?, posted by PhoenixGirl on March 3, 2001, at 15:35:40
> I want to hear from people who treat their depression with a stimulant, do not have ADD, and also have not developed tolerance to the stimulant. I want to see if this is possible, or how likely it is. Thanks
I fit your description (mostly).
I have been diagnosed as experiencing atypical depression. I have been depressed for 22 years and I don't believe I have any symptoms of ADD. On stimulants - particularly Provigil - I am completely cured and no other medications alone or combined have cured me.
I did develop a tolerance for Provigil. To combat that tolerance I added a small dose of an antipsychotic (amisulpride) and skip provigil one day a week.
Posted by mellie on March 11, 2001, at 9:19:03
In reply to Who has depression without ADD, and takes stims?, posted by PhoenixGirl on March 3, 2001, at 15:35:40
> I want to hear from people who treat their depression with a stimulant, do not have ADD, and also have not developed tolerance to the stimulant. I want to see if this is possible, or how likely it is. Thanks
I hope I'm not posting twice, I got a bit stuffed up on the first go round....I have been taking ssri for years for depression and OCD. Currently I'm on Celexa and my pdoc has added in Ritalin. I've only been taking the Ritalin for 2 months, so I can't remark on the possibility of tolerance buildup. I have experienced a marked increase in my ability to concentrate and follow through on ideas.
I have not been diagnosed with ADHD. However, this is interesting, after hearing my side effects from past experiments with a certain non-legal drug, my pdoc hypothesized that I might benefit from a stimulant/ssri combo. The results are generally favorable at this point. It does give me a bit of a "lift". I am interested in thoughts and similar experiences. Thanks.
This is the end of the thread.
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